Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study
BackgroundTumor heterogeneity poses major clinical challenges in high-grade gliomas (HGGs). Quantitative radiomic analysis with spatial tumor habitat clustering represents an innovative, non-invasive approach to represent and quantify tumor microenvironment heterogeneity. To date, habitat imaging ha...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2022.885291/full |
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| author | Michele Bailo Michele Bailo Nicolò Pecco Marcella Callea Paola Scifo Filippo Gagliardi Luca Presotto Valentino Bettinardi Federico Fallanca Paola Mapelli Paola Mapelli Luigi Gianolli Claudio Doglioni Nicoletta Anzalone Nicoletta Anzalone Maria Picchio Maria Picchio Pietro Mortini Pietro Mortini Andrea Falini Andrea Falini Antonella Castellano Antonella Castellano |
| author_facet | Michele Bailo Michele Bailo Nicolò Pecco Marcella Callea Paola Scifo Filippo Gagliardi Luca Presotto Valentino Bettinardi Federico Fallanca Paola Mapelli Paola Mapelli Luigi Gianolli Claudio Doglioni Nicoletta Anzalone Nicoletta Anzalone Maria Picchio Maria Picchio Pietro Mortini Pietro Mortini Andrea Falini Andrea Falini Antonella Castellano Antonella Castellano |
| author_sort | Michele Bailo |
| collection | DOAJ |
| description | BackgroundTumor heterogeneity poses major clinical challenges in high-grade gliomas (HGGs). Quantitative radiomic analysis with spatial tumor habitat clustering represents an innovative, non-invasive approach to represent and quantify tumor microenvironment heterogeneity. To date, habitat imaging has been applied mainly on conventional magnetic resonance imaging (MRI), although virtually extendible to any imaging modality, including advanced MRI techniques such as perfusion and diffusion MRI as well as positron emission tomography (PET) imaging.ObjectivesThis study aims to evaluate an innovative PET and MRI approach for assessing hypoxia, perfusion, and tissue diffusion in HGGs and derive a combined map for clustering of intra-tumor heterogeneity.Materials and MethodsSeventeen patients harboring HGGs underwent a pre-operative acquisition of MR perfusion (PWI), Diffusion (dMRI) and 18F-labeled fluoroazomycinarabinoside (18F-FAZA) PET imaging to evaluate tumor vascularization, cellularity, and hypoxia, respectively. Tumor volumes were segmented on fluid-attenuated inversion recovery (FLAIR) and T1 post-contrast images, and voxel-wise clustering of each quantitative imaging map identified eight combined PET and physiologic MRI habitats. Habitats’ spatial distribution, quantitative features and histopathological characteristics were analyzed.ResultsA highly reproducible distribution pattern of the clusters was observed among different cases, particularly with respect to morphological landmarks as the necrotic core, contrast-enhancing vital tumor, and peritumoral infiltration and edema, providing valuable supplementary information to conventional imaging. A preliminary analysis, performed on stereotactic bioptic samples where exact intracranial coordinates were available, identified a reliable correlation between the expected microenvironment of the different spatial habitats and the actual histopathological features. A trend toward a higher representation of the most aggressive clusters in WHO (World Health Organization) grade IV compared to WHO III was observed.ConclusionPreliminary findings demonstrated high reproducibility of the PET and MRI hypoxia, perfusion, and tissue diffusion spatial habitat maps and correlation with disease-specific histopathological features. |
| first_indexed | 2024-04-12T09:04:52Z |
| format | Article |
| id | doaj.art-42d4eff90ca244f081bb1c2c8c2a7582 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-04-12T09:04:52Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-42d4eff90ca244f081bb1c2c8c2a75822022-12-22T03:39:07ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2022-07-011610.3389/fnins.2022.885291885291Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary StudyMichele Bailo0Michele Bailo1Nicolò Pecco2Marcella Callea3Paola Scifo4Filippo Gagliardi5Luca Presotto6Valentino Bettinardi7Federico Fallanca8Paola Mapelli9Paola Mapelli10Luigi Gianolli11Claudio Doglioni12Nicoletta Anzalone13Nicoletta Anzalone14Maria Picchio15Maria Picchio16Pietro Mortini17Pietro Mortini18Andrea Falini19Andrea Falini20Antonella Castellano21Antonella Castellano22Vita-Salute San Raffaele University, Milan, ItalyDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS Ospedale San Raffaele, Milan, ItalyNeuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, ItalyPathology Unit, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyPathology Unit, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyNeuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyDepartment of Nuclear Medicine, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyDepartment of Neurosurgery and Gamma Knife Radiosurgery, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyNeuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, ItalyVita-Salute San Raffaele University, Milan, ItalyNeuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Milan, ItalyBackgroundTumor heterogeneity poses major clinical challenges in high-grade gliomas (HGGs). Quantitative radiomic analysis with spatial tumor habitat clustering represents an innovative, non-invasive approach to represent and quantify tumor microenvironment heterogeneity. To date, habitat imaging has been applied mainly on conventional magnetic resonance imaging (MRI), although virtually extendible to any imaging modality, including advanced MRI techniques such as perfusion and diffusion MRI as well as positron emission tomography (PET) imaging.ObjectivesThis study aims to evaluate an innovative PET and MRI approach for assessing hypoxia, perfusion, and tissue diffusion in HGGs and derive a combined map for clustering of intra-tumor heterogeneity.Materials and MethodsSeventeen patients harboring HGGs underwent a pre-operative acquisition of MR perfusion (PWI), Diffusion (dMRI) and 18F-labeled fluoroazomycinarabinoside (18F-FAZA) PET imaging to evaluate tumor vascularization, cellularity, and hypoxia, respectively. Tumor volumes were segmented on fluid-attenuated inversion recovery (FLAIR) and T1 post-contrast images, and voxel-wise clustering of each quantitative imaging map identified eight combined PET and physiologic MRI habitats. Habitats’ spatial distribution, quantitative features and histopathological characteristics were analyzed.ResultsA highly reproducible distribution pattern of the clusters was observed among different cases, particularly with respect to morphological landmarks as the necrotic core, contrast-enhancing vital tumor, and peritumoral infiltration and edema, providing valuable supplementary information to conventional imaging. A preliminary analysis, performed on stereotactic bioptic samples where exact intracranial coordinates were available, identified a reliable correlation between the expected microenvironment of the different spatial habitats and the actual histopathological features. A trend toward a higher representation of the most aggressive clusters in WHO (World Health Organization) grade IV compared to WHO III was observed.ConclusionPreliminary findings demonstrated high reproducibility of the PET and MRI hypoxia, perfusion, and tissue diffusion spatial habitat maps and correlation with disease-specific histopathological features.https://www.frontiersin.org/articles/10.3389/fnins.2022.885291/fullhigh-grade gliomaPETMRIhabitatshypoxia imagingperfusion-weighted imaging |
| spellingShingle | Michele Bailo Michele Bailo Nicolò Pecco Marcella Callea Paola Scifo Filippo Gagliardi Luca Presotto Valentino Bettinardi Federico Fallanca Paola Mapelli Paola Mapelli Luigi Gianolli Claudio Doglioni Nicoletta Anzalone Nicoletta Anzalone Maria Picchio Maria Picchio Pietro Mortini Pietro Mortini Andrea Falini Andrea Falini Antonella Castellano Antonella Castellano Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study Frontiers in Neuroscience high-grade glioma PET MRI habitats hypoxia imaging perfusion-weighted imaging |
| title | Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study |
| title_full | Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study |
| title_fullStr | Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study |
| title_full_unstemmed | Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study |
| title_short | Decoding the Heterogeneity of Malignant Gliomas by PET and MRI for Spatial Habitat Analysis of Hypoxia, Perfusion, and Diffusion Imaging: A Preliminary Study |
| title_sort | decoding the heterogeneity of malignant gliomas by pet and mri for spatial habitat analysis of hypoxia perfusion and diffusion imaging a preliminary study |
| topic | high-grade glioma PET MRI habitats hypoxia imaging perfusion-weighted imaging |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2022.885291/full |
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